Walberton (South Coast)

Updated 10 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience who assisted the inspection remotely. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Walberton (South Coast) is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Walberton (South Coast) is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke/ communicated with 8 people who used the service and 7 relatives about their experience of the care provided. Some people who used the service who were unable to talk with us using speech so we used different ways of communicating including using Makaton and their body language.

We spoke with 8 members of staff including the registered manager, area manager, deputy manager, senior support workers and support workers.

We used the Short Observational Framework for Inspection (SOFI)/ spent time observing people. SOFI is a way of observing care to help us understand the experience of people who could not talk with us

We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 10 January 2023

About the service

Walberton (South Coast) is a residential care home. The service consisted of four houses. Russett, Melrose, Pippin and Fortune. Russet and Melrose were bigger than most domestic style properties. It is registered to provide support for up to 33 people living with complex needs, learning disabilities and autistic people. Some people had additional health conditions including dementia, diabetes and epilepsy. There were 23 people, living at the service, at the time of the inspection.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Some people had limited opportunities to build skills and participate in individual activities. Staff tried to focus on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Work had begun with some people but we were told there were not enough staff to provide this support consistently for everyone. Each person had their own room, which were generally personalised to meet their needs and preferences. Some people had access to an on-site day service and others had employment in the apple enterprise owned by the provider. People valued these opportunities and they did go some way to mitigate people living in large groups in houses that were not domestic in scale or staffed to maximise people’s independence.

The service worked with people to plan for when they experienced periods of distress so their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid restraining people. Staff learned from those incidents and how they might be avoided or reduced.

Staff enabled people to access specialist health and social care support in the community. Staff supported people to make decisions following best practice in decision-making.

Right care

People experienced mixed quality of care. People and their families told us staff were kind and supportive but there were not always enough of them. We observed staff respecting people’s dignity and ensured people had the right to have their say on their care and support. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing. Staff and people worked together to assess risks people might face. Staff encouraged people to take positive risks.

Right culture

People did not always lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the provider, management and staff. There was mixed understanding or opportunities to apply active support approaches. The provider had not fully considered people’s needs and wishes in the planning and deployment of staff, for example some people told us they wanted to cook their own evening meals, but this happened infrequently so others could have a turn. Managers and staff clearly tried to deliver person centred support but told us this was difficult when so many people lived together with differing needs and wishes. People had communication passports and staff knew people well. However, improvement could be made by providing staff with further training regarding autism and sensory needs of people. Managers and staff were trying to further develop these areas locally within the limitations of the layout and staffing structure of the service.

People received good quality health care, support and treatment because trained staff and specialists could meet their needs. Most staff knew and understood people well but there was a reliance on agency staff who did not always know people well.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update The last rating for this service was requires improvement (published 02 May 2019) and there were breaches of regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found enough improvements had been made and the provider was no longer in breach of regulation 17, good governance. Systems are not all fully embedded so this does remain an area that requires improvement.

At this inspection we found a breach of regulation 18 staffing.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 19 February 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walberton (south coast) on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.